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Projections of Medicare's future debt obligations are staggering.Even without any prescription drug benefits, current participantswill be owed $13 trillion. New generations, whose taxes should bepaying off current obligations, will impose another $25 trillion indebt to the system. Reformers should consider adopting features ofthe Federal Employees Health Benefit Program (FEHBP), whichemphasizes consumer choice and competition among health plans andhas successfully controlled costs for decades.

Social Security and Medicare have promised $37 trillion more inbenefits to senior and disabled workers than the programs will beable to pay.

Seniors should realize that efforts to control costs in Medicarewill likely tie the hands of physicians by limiting treatmentoptions, as they have in Medicaid. Instead of a system based ongovernment central planning and price fixing, Congress shouldencourage market competition and give full sway to patient choice.

President George W. Bush and many in Congress cite tax relief asthe centerpiece of their economic agenda. Lawmakers who vote forthe Medicare drug benefit are voting for a $2 trillion taxincrease. Responsible lawmakers who oppose such substantial taxincreases should look beyond the 2004 election and examine theburden that a Medicare drug burden will impose on futuregenerations.

“If you think health care is expensive now, wait until you see what it costs when it’s free,” P.J. O’Rourke once said. He may as well have been describing the Medicare drug benefit being hatched by President Bush and Congress. They’re on the verge of approving the most expensive government expansion since the Great Society.